Brain tumor neurosurgery in the COVID-19 era

Neurocirurgia de tumor cerebral na era COVID-19

Resumo

Introduction: COVID-19 is a current medical breakthrough. It has led to significant pressure on health systems worldwide, with care and structure being directed primarily to disease control. However, other pathologies did not cease to exist. In the specific case of brain tumors, we deal with a pathology with a high potential for life-threaten, even in benign cases. Objective: The objective of this study is to evaluate a sample of patients with brain tumors undergoing neurosurgical procedure during the pandemic period to determine the impact of COVID-19 pandemic on brain tumor surgery in a single Brazilian tertiary institution. Methods: We consecutively evaluated our patients prior and after COVID-19 pandemics during hospital stay. We included in analysis patients diagnosed and submitted to neurosurgical treatment of all primary and secondary brain neoplasms. Most cases are symptomatic brain metastases and gliomas. We excluded from analysis patients with asymptomatic or olygosymptomatic slow-growing and benign tumors (including meningiomas and schwannomas). Results: There was a decrease of 54% in total number of surgeries and 30% of brain tumor surgeries during COVID-19 pandemics. There was an increase of mortality rate between pre-COVID era and post- COVID era (4% versus 19%), however it was not statistically significant. Discussion: Neurooncological patients are facing a specially complex situation during COVID-19 pandemics. On one hand, they need to follow caution measures but on the other hand they need proper routine and emergency evaluation when necessary. They are more prone to complications in hospital or outward environments.